An
intraocular lens implant placed permanently
in the eye once the natural lens has been
removed helps reduce or eliminate the need
for glasses or contact lenses after
refractive lensectomy.

Refractive lens exchange is
a procedure designed to reduce a person’s dependence on
glasses or contact lenses. The eye has a lens that works
much like the lens of a camera to keep things in focus.

Sometimes, the power of that natural, human lens is not
correct for the eye. The result is blurred vision from
either nearsightedness, or farsightedness or
astigmatism.

Refractive lens exchange can correct
these vision disorders by replacing the eye's natural lens with an
artifical plastic lens known as an intra-ocular lens implant. The
power of the artificial lens that will work best is determined by
painless in-office measurements done before the procedure.

The latest advance in refractive lens exchange surgery is the use of
bifocal-like intraocular lens implants called “multifocal implants”
which not only reduce or eliminate the need for glasses to see far
away, but which also make it possible to read and see up-close with
little or no need for glasses.

The tip of
a pencil-sized instrument painlessly vacuums
the clear lens out of the eye through a tiny
incision after breaking it into fragments
with ultrasound.

The refractive lens exchange procedure
is painless. It usually takes about 20 minutes and is
performed under a local or topical anesthetic in an
outpatient surgery center. Once the eye is numb, a tiny
opening about the size of pencil tip is made in the
cornea, or clear front window of the eye. The tip of a
pencil-shaped instrument is then placed through the
incision and emits sound waves (ultrasound) to break the
natural lens into tiny fragments. This same instrument
then vacuums out the fragments.

Next, an appropriately-powered plastic implant is folded
up like a taco and inserted through the same small
incision. The lens implant unfolds inside the eye and
remains there permanently. The incision is so small that
it generally requires no stitches. You are on your feet
the same day, back to almost all of your normal
activities the next day, and usually seeing very well –
with little or no need for glasses—within a day or two.

The same surgical technique is used to remove
cataracts, usually in people over the age of 65. A
cataract is a cloudy lens that prevents a person
from seeing well even with his or her best pair of
glasses. Cataracts usually occur as a normal part of
aging. Refractive lens exchange involves removing
one’s natural lens while it is still clear, and not
yet cloudy. While cloudy vision is the main
indication for cataract surgery, a desire to
decrease or eliminate the need for glasses or
contact lenses is the main indication for refractive
lens exchange.

Clear lens
removed in
refractive lens exchange

Yellowed,
cloudy lens removed in cataract surgery

Refractive lens exchange is most often
recommended when a patient is not a good candidate for laser vision
correction procedures to reduce or eliminate the need for glasses or
contacts. They may have a need for correction that is beyond the
range of laser vision correction, corneas that are too thin for
laser vision correction, or an eye condition that makes laser vision
correction unsafe or unwise.

Refractive lens exchange is not generally recommended for people
under 45 years of age, although there can be exceptions. It is not
covered by insurance, unless one’s natural lens is affected by a
significant cataract. And, as with any surgery, complications are
possible. However, it is generally considered to be quite safe and
quite effective for patients who are appropriate candidates.

At the
time of your visit, we
will determine whether or not
you are a
good candidate for this procedure, and will
explain it in more detail.